<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <title>内蒙古元展科技有限公司</title>
</head>
<body>

<div class="col-md-12">
    <div class="form-group">
        <label class="col-sm-3 control-label">纯文本：</label>
        <div class="col-sm-9">
            <p class="form-control-static">内蒙古元展科技有限公司</p>
        </div>
    </div>
    <div class="form-group">
        <label class="col-sm-3 control-label">姓名：</label>
        <div class="col-sm-9">
            <input type="text" name="" class="form-control" placeholder="请输入姓名">
        </div>
    </div>
    <div class="form-group">
        <label class="col-sm-3 control-label">您的想法/建议：</label>
        <div class="col-sm-9">
            <textarea type="text" name="" class="form-control" placeholder="请输入文本"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="col-sm-3 control-label">期望接收反馈的时间：</label>
        <div class="col-sm-9">
            <div class="input-group date"> <span class="input-group-addon"><i class="fa fa-calendar"></i></span>

                <input type="text" class="form-control" value="2018-04-20">
            </div>
        </div>
    </div>
</div>
</body>
</html>